Hypertrophy of the pharynx (the so-called third tonsil), which is most often diagnosed in preschool children, requires prompt medical intervention. The third tonsil can lead to many serious complications, including hearing loss, underweight and developmental disorders, and even changes in the shape of the face. What are the causes and symptoms of adenoid hypertrophy? How is the treatment going?

Pharyngeal hypertrophy(also calledthird almond ) indicates an excessive growth of the tonsil, which is located behind the nose, in the place where the the nasal passages into the throat. The third almond begins to develop after birth. Then it grows very quickly - especially during early childhood. Then it is very important for the proper functioning of the body, because - as part of the immune system - it protects the child against bacteria, viruses and other pathogens from the external environment. The closer to puberty, the more pronounced the adenoid shrinks as its role in the maturing immune system loses its importance. It eventually fades away in the following years of life. As a result,third tonsil hypertrophy in adultsis very rare. It is most common in children from 3 to 6 years of age.

Tonsil hypertrophy: causes

The causes of third tonsil hypertrophy are unknown, but there are many risk factors:

  • frequent and chronic respiratory and oral infections
  • having some infectious diseases
  • allergies
  • genetic predisposition (adenoid hypertrophy in parents or siblings)

Tonsil hypertrophy: symptoms

  • mouth breathing - the child's mouth is always open, both during the day and at night
  • snoring
  • recurrent infections of the upper and lower respiratory tract - the child's mouth is constantly open, as a result of which the mucous membranes of the throat dry out, and the local immunity decreases
  • chronic runny nose combined with discharge of secretions down the back of the throat, which is accompanied, among others, by unpleasant smell from the mouth
  • change of voice timbre, speaking through the nose
  • disturbed sucking reflex or difficulty eating (fatiguewhile eating, sometimes even vomiting)
  • recurrent otitis media (exudative otitis media or acute otitis media) with pain, a feeling of fullness and a feeling of fluid overflow in the ear
  • Hearing loss (resulting from the pressure of the enlarged tonsil on the Eustachian tubes)
  • chronic conjunctivitis (nasal inflammation can spread to the tear ducts)
  • flat chest (as a result of continuous shallow breathing)
  • tendency to slouch
  • other - hyperactivity, bedwetting, underweight, growth disorders, learning difficulties, trouble concentrating

Later malocclusions and changes in the facial skeleton appear (the so-called adenoid face - stronger development of the mandible in relation to the maxilla and the rest of the craniofacial face, mandible retraction, long face syndrome, gothic palate - narrow and strongly arched).

overgrown tonsil: diagnosis

If there is a suspicion of an enlarged third tonsil, the examination is performed with a fiberscope (endoscope with a camera). It is the most accurate test that leaves no doubt about the state of the art.

The lateral x-ray of the nasopharynx may be an auxiliary examination.

During the diagnosis, the doctor should exclude malignant neoplasms of the mouth and throat and juvenile angiofibroma.

Treatment of the third tonsil

In the case of a not too enlarged third tonsil, the doctor may order observation and conservative treatment.

However, if an overgrown adenoid impairs the patency of the nose, causes constant breathing through the mouth, snoring, hearing loss or ear inflammation, performadenoidectomy , i.e. surgical removal of the pharyngeal tonsil.

Due to the fact that the pharyngeal adenoid plays an important role in the protection of the organism of the youngest, adenoidectomy is avoided in children under 2 years of age. In older children, the tonsil loses its functions, therefore there are no obstacles to remove it.

The operation of pharyngeal tonsil removal is not performed when the soft palate is too short and the child has a cleft soft palate.

Can the removed adenoid grow back?

If there is a small amount of lymphoid tissue left after the surgery, due to, for example, an upper respiratory tract infection (or other strong stimulation of the immune system), the pharyngeal tonsil may again overgrow and require re-removal (readenotomy). However, this happens very rarely. It is known that the risk of recurrent adenoid growth increases with its removalhappened before the child was 4 years old.

Third tonsil

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